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Job Title: Membership Rep I
Duration: 3 Months
Location: Roanoke, Virginia 24011

Shift Timings: Mon-Fri 8:00 am - 4:30 pm

Description:
• What type of experience do you want to see on paper I'd like to see some type of knowledge of insurance, preferably Med Supp.
• Will these candidates be taking inbound phone calls and if so what is the volume expected Inbound calls will only be those which the associate would be expecting. Typically the associate would reach out to the customers either via phone or email.
• Will you consider candidates without healthcare experience My preference is they have some knowledge.
• What type of metrics will the candidates be measured on They will be measured on the number of work produced. In this case, applications processed. We have all associates set up for the same measures.
• Is there a chance for extension or hire Yes extensions are always a possibility. At this time, I only have one open position and that will be filled before these associates will be hired. It does not mean that another associate from my department leaves for another job and that would open the possibility of a temp becoming full time.
• What does the training process look like The associates will be trained on guaranteed issue guidelines for all of the states which we service (17 states) and will be responsible to retrieve any information which is missing from an application.
• What does your interview timeline and process look like (i.e. phone or in person) It could be a little of both but preferably in person.
• Start date 9/10 (is this a hard start date) Yes

Responsibilities:
• Responsible for enrollment, billing activities and/or maintaining assigned accounts. Must pass the appropriate pre-employment test battery.
• Primary duties may include, but are not limited to: Responds to incoming calls and may initiate outgoing calls, providing customer service to plan members, providers and employer groups by answering benefit questions, resolving issues and educating callers.
• Verifies enrollment status, makes changes to records, researches and resolves enrollment system rejections; addresses a variety of enrollment questions and/or concerns received by phone or mail. May be responsible for billing and delinquency processes for assigned groups.
• Ensures accuracy and timeliness of the membership and billing function. Responds to inquiries concerning enrollment processes. Maintains enrollment database. May order identification cards. Determines eligibility and applies contract language for each case assigned.
• Performs error output resolution for electronic eligibility and processes error discrepancy list. Bills, collects premiums and reconciles payments. Maintains and reconciles premium bill, self-bill and individual billed accounts.
• Notifies clients of premium discrepancies through payment adjustment notices and detailed audits. Screens all forms and data for all paperwork received from Sales and/or Underwriting for new group and/or group re-classing benefits. Makes request to Underwriting, Sales or Brokers for missing information and/or forms needed for new group or re-class of existing group.
• May be responsible for loading rates to new groups and renewal/re-class groups within the appropriate system. Screens group for benefits to determine if existing or new, recognizing when benefits are not standard and handling as appropriate.
• Thoroughly documents inquiry outcomes for accurate tracking and analysis. Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner. Performs basic job functions with help from co-workers, specialists and managers on non-basic issues.
• Requires a HS diploma or GED; up to 1 year of related experience; or any combination of education and experience, which would provide an equivalent background.